Traumatic brain injury (TBI) is a major source of long-term disability and dementia. Microglia, long-lived immune cells of the brain, activate to multiple reactive states in response to injury. The extent of pro-inflammatory activation correlates with the severity of neurological impairments, suggesting that unresolved activation is pathogenic. The proposed research is highly significant because it will evaluate a clinically safe intervention to ameliorate harmful TBI-induced microglial activation that may contribute to dementia and other chronic neurological deficits following TBI. Our data suggest that a metabolic shift from oxidative phosphorylation to glycolysis during pro-inflammatory activation involves impairment to the lysosomal turnover of damaged mitochondria by mitophagy, which is followed by Complex I subunit degradation. Idebenone restores oxygen consumption by damaged mitochondria and attenuates pro-inflammatory nitric oxide and interleukin-1beta production. The restoration of oxygen consumption by idebenone decreases intracellular oxygen concentration. We found that simply lowering oxygen concentration by incubating cells under hypoxia prevents Complex I degradation and mitophagy impairment. Unexpectedly, antioxidants failed to yield similar rescue, suggesting a role for oxygen that is independent of oxidative stress. Using proteomics, we discovered a marked accumulation of prolyl 3-hydroxylase 2 (P3H2) in a mitochondria/lysosome-enriched cell fraction. P3H2 gene expression within the brain is microglia-specific, and our preliminary data show elevated P3H2 in mouse peri-contusional cortex after TBI. P3H2 enzyme uses oxygen as a substrate for proline hydroxylation of target proteins. Idebenone may suppress the activity of P3H2 by decreasing oxygen availability, preventing P3H2 from post-translationally modifying mitochondria or lysosome proteins involved in quality control. This study will test the central hypothesis that idebenone suppresses TBI-induced microglial activation, chronic neurodegeneration, and cognitive deficits by reversing P3H2-dependent inhibition of mitophagy. The following specific aims employ state-of-the-art mouse models to monitor microglial mitochondrial turnover and include novel methods to sort and study microglia ex vivo based on mitochondrial function. The experiments in Aim 1 will test the prediction that idebenone rescues mitophagy in pro-inflammatory microglial cells by decreasing intracellular oxygen concentration, thereby inhibiting P3H2 activity. Using both male and female mice and considering sex as a variable, the experiments in Aim 2 will test the prediction that idebenone or genetic P3H2 knockout ameliorates TBI-induced pro-inflammatory microglia accumulation and neurological deficits by rescuing microglial mitophagy. Positive outcomes will support translational studies of idebenone to treat TBI-induced dementia, with the potential to help millions of men and women living with the devastating consequences of TBI.